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Biomedical subjects

F Stösslein

Publications and source records attributed to F Stösslein.

At least 19 recordsLinked to original sources
PubMed2005

[Rheumatoid arthritis at the cervical spine -- an underestimated problem].

BACKGROUND AND OBJECTIVE: The involvement of the cervical spine in rheumatoid arthritis can be essential regarding prognosis and mortality. The cervical myelopathy due to pannus formation and/or subluxation can be fatal. Aim of this study was to demonstrate the possible changes seen by MRI, and to establish a risk-profile for the individual patient. PATIENTS AND METHOD: Within a period of 24 months 214 patients with active RA were included. Clinical and laboratory data were obtained and plain radiographs of the cervical spine were taken. In patients with pathological findings on X-ray an MRI was performed (36 patients). RESULTS: Within the group of 214 patients 36 were identified to get an cervical spine MRI. In all cases the MRI showed significant changes: in 7 (19.5 %) pannus surrounded the dens, with additional erosions in one patient (2.7 %). In 25 (69.5 %) atlanto-axial-subluxation was present, 7 (19.5 %) showed a spondylodiscitis below C2. In 10 (27.8 %) a cervical myelopathy due to pannus or subluxation was present. There was no correlation of the MRI-results with symptoms and findings by examination. The patients with cervical spine disease were in all stages of RA. The majority was rheumatoid-factor positive. 5 out of 10 patients with cervical myelopathy showed neurological deficits: 3 patients died in consequence of neural compression, 2 patients underwent surgery successfully. CONCLUSION: The early detection of a cervical spine involvement in RA is essential to avoid possibly fatal complications. The only reliable method to achieve this goal has to include radiographic diagnostic including MRI of the cervical spine. Only this approach can answer the question of the right time-point for surgery. In daily clinical practice the cervical-spine involvement in RA is still underestimated.

Adolescent↗
PubMed2003

[Spontaneous rupture of a lumbar artery. A rare etiology of retroperitoneal hematoma].

A ruptured lumbar artery is an uncommon lesion for a retroperitoneal hematoma. This report describes a 77-year-old man with bladder carcinoma who developed a spontaneous retroperitoneal hemorrhage during anticoagulation therapy for an artificial cardiac valve. The diagnosis was suggested by computed tomography scan and confirmed with angiography. Successful treatment consisted of occluding bleeding arteries by transcatheter embolization.

Aged↗
PubMed2001

[Arteriovenous fistula of the maxillary artery, eustachian tube dysfunction and tinnitus after Le Fort I osteotomy].

A 36-year-old woman with a maxillary retrognathia underwent a Le Fort I osteotomy. Postoperatively, she complained of pulsatile noise and hearing loss in the left ear. Carotid arteriography revealed an arteriovenous fistula of the left maxillary artery; in addition, a persistent eustachian tube dysfunction with left middle ear effusion was noticed. After embolization of the fistula and ventilation tube treatment, improved hearing and a significant reduction of tinnitus were achieved. Arteriovenous fistulas after orthognathic surgery are very rare. Postoperative eustachian tube dysfunction has not yet been reported in the literature.

Adult↗
PubMed1998

Embolization treatment of bleeding complications in pancreatitis.

Pseudoaneurysm following chronic pancreatitis is a severe complication that can lead to massive gastrointestinal bleeding. Surgical treatment means high risk for the patient. We report on two patients in whom the bleeding was managed by percutaneous transvascular embolization, a relatively non-invasive and successful method with low risk. The goal was either the definitive arrest of bleeding or stabilization of the patient to enable a surgical procedure. Embolization coils are the material most utilized for vessel occlusion. In patients with bleeding complication following pancreatitis, if sonography or computed tomography demonstrates a pseudoaneurysm, we recommend angiographic visualization and immediate subsequent embolization.

Aged↗
PubMed1997

[Interventional radiology--current status and future importance].

The main methods of interventional radiology are described under clinical aspects. Treatment in peripheral arterial occlusive diseases by angioplasty and special other methods (stents, thrombectomy), as well as in bleeding management by embolization or different diagnostic and therapeutic techniques associated with oncologic diseases are performed. Minimal-invasive procedures are one of the most important courses of the practical medicine in the future.

Cost Control↗
PubMed1996

Comparison of tissue plasminogen activator and urokinase in the local infiltration thrombolysis of peripheral arterial occlusions.

Recanalization of the vascular lumen by means of local fibrinolysis is of major importance in the treatment of peripheral arterial occlusive disease. While urokinase and streptokinase have been extensively used for local fibrinolysis, there have been few studies of infiltration thrombolysis with genetically engineered tissue plasminogen activator (rt-PA). The aim of the investigation reported here was to establish whether there is any difference between urokinase and rt-PA in the short- and long-term outcome of local fibrinolytic therapy. One-hundred twenty patients (70 men, 50 women) with acute or subacute femoral (n = 21), femoropopliteal (n = 33), popliteal (n = 13) or popliteocrural (n = 53) thrombotic occlusions were randomized to local lysis using urokinase or rt-PA, and 6 months later follow-up investigations took place. Recanalization of thrombotically occluded vessels, particularly in the lower leg, was found more frequently, and after treatment of shorter duration, with rt-PA. Large local haematomas occurred in 8% of cases in the urokinase group and 15% in the rt-PA group. No serious haemorrhages were encountered in either group. Six months after treatment, the rt-PA group showed lower rates of Fontaine stage III and IV disease and amputation than the urokinase group, with a higher number of patients in Fontaine stage IIb. This study shows that local lysis with rt-PA yields better results than urokinase, not only in the short term but also 6 months later.

Adult↗
PubMed1993

[Implantation of vena cava filters in acute pulmonary embolism].

The long-term results of 222 patients (pts) with transvenously implanted vena cava filters are critically reviewed. A total of 98 pts were given a Mobin-Uddin filter, 102 pts a Günther filter, and 16 pts a LGM filter. Among the serious complications observed during long-term follow-up were vena cava occlusions and increasing symptoms ranging from congestion of the deep leg veins, perforations into ureters, fractures and embolizations of the filters in up to 40% of the patients, if Günther filters were implanted.

Equipment Design↗
PubMed1992

[Therapeutic embolization of pulmonary arteriovenous malformations].

It is reported on the practicability and the results of therapeutic embolizations in 7 patients with pulmonary av-malformations. The embolizations were carried out by detachable balloons. In all cases there were immediate and well-defined occlusions. In direct fistulas the embolization represents a curative procedure. However, in cases of angiomatous malformations with slow flow character, only a reduction of shunt or decreasing of size is obtained.

Angiography↗
PubMed1989

[Embolization therapy using detachable balloons].

Report on the application of a new (valve equipped) detachable balloon for percutaneous transvasal embolization therapy in 372 patients with (noncerebral) curative preoperative and palliative indications.

Embolization, Therapeutic↗
PubMed1988

[Treatment of idiopathic varicocele in children and adults by occlusion of the testicular vein with a detachable balloon].

The results of varicocele treatment by balloon occlusion of the testicular vein in 22 children and 29 adults are compared with the results after operative ligation of the testicular vein in 95 patients. In 6 out of 22 children (27%) the varicocele persisted after balloon occlusion, compared with 3 out of 29 adult patients (10%). These results in adults are comparable to the results after operative ligation of the testicular vein, whereas the complication rate was significantly lower after balloon occlusion in comparison with operative treatment.

Adolescent↗
PubMed1987

[Improvement in the prognosis of renal cell carcinoma by percutaneous transvascular embolization].

In a retrospective study of 303 patients with renal cell carcinomas the prognostic influence of the percutaneous transvasal embolization of the renal artery was demonstrated. In form of the life-table-method we compared statistically the survival rates of preoperatively or palliatively embolized patients with such ones who were only nephrectomized or treated only symptomatically. In the tumour stages T2 and T3 the preoperative percutaneous transvasal embolization leads to a clearly higher survival rate; in stage T2 statistically significant. After palliative embolization the improvement of the prognosis is evident compared with the inoperable patients who were treated only symptomatically. The prognosis after palliative preoperative percutaneous transvasal embolization and retarded nephrectomy is not worse than after preoperative percutaneous transvasal embolization and immediate nephrectomy. The effect of the preoperative and palliative embolization improving the prognosis should incite all partners who up to now objected to this therapeutic method to reconsider their therapy concept.

Carcinoma, Renal Cell↗
PubMed1985

[Therapeutic vascular embolization in life-threatening gynecologic hemorrhages].

Report on 12 women with acute massive or chronic tumor hemorrhage, treated with embolisation. There were 7 women with cervical cancer T3/T4, 3 women with adenocarcinoma (2mal primary progressive, one with metastases in lymph-nodes), one woman with progressive malignant mesenchymale tumor in vagina and one with local persistent ovarian cancer. In 10/12 cases hemorrhage stopped immediately after embolisation. In 3 cases, after one-sided embolization, repeated procedure of the contralateral vessel was necessary. In 2/12 cases side-effects like fever and subileus, and, in one case, complications like skin necrosis and bladder-vagina-fistula were seen. In all patients temporary improvement of life-quality were found. Low risk and good tolerance of this palliative therapy are emphasized.

Adenocarcinoma↗